Friday, March 26, 2010

The doctor has spoken...rather the RE.

Hi folks, sorry this was delayed.  I haven't had time to think about what Dr. H said, or at least enough to write about it.  So this was my Thursday.

Woke up and worked out, still with my lip big enough to eat Tucson. But since my workout friend was going to be banging on my door at 5:45 am, I had to get up.  And it wasn't bad, until about the end of the workout where I just couldn't continue.  Something with my head and tummy just wasn't meshing well.  She left and I actually went back to bed for another 45 mins or so, until J's alarm went off and he crawled out.  Because, when he crawls out, I am late!  However, surprise to me, he wanted to get to work early because he was leaving early for our Doctor appointment.  Smart man.  But by that point, I was up already.

On the way to work, stopped and got our girl flowers (the brightest daisies I could find)  to hopefully help with some of the heartache going on.  And then stopped to get more lip stuff...someone said carmex, and even though I wasn't sure about it, I did it (and on a side note, I think it has helped!).  Our girl (who had the miscarriage) had not come in, and I can't say that I blamed her...I would have been curled in a ball waiting for the Earth to swallow me.  Anyway, my Boss/Mom ended up taking them to her at home on her way to an appointment and she loved them.  I got a text and it said they made her day.  It was the least we could do.  And it made her happy, that's all we could ask for.

Finally, 1 pm rolled around and it was time for me to scoot to Dr. H's office.  J was meeting me there.   I got there first and someone else was already talking to the receptionist at the window.  However, she looked at me, mouthed my name and pointed that I should sit down.  How sad is that that I don't even have to give them my name, they know my face?  Sorry, side note.  J got there and I went around to talk to the other receptionist, I had requested a full printout of our file and I wanted to make sure they got it.  Their office is completely paperless.  So when you take in records, they scan them in and then give them back.  Every appointment we had, had notes to it that we didn't have.  So now we do.

About 1:40 pm, Dr. H came out and got us for our 1:30 appt.  He was in scrubs and I think someone had told me that this was an "IVF week" at the office.  He welcomed us, then corrected himself saying he knew we didn't like to come see him.  He noticed my lip and I told him what had happened, so there was some brief discussion about sunburns and the air show.  Although, he said he didn't notice it until I was talking.  So we talked.  He started to get into it, and I interuppted him with the news that I hadn't spotted for the last three months and that AF was late this month.  He said the lack of spotting was awesome!  And that this month could have been a chemical pregnancy, but we'll never know because there wasn't a positive test.  But both were good signs.  He discussed my recent blood work saying that everything was good and nothing to try to improve.  J brought up Volleyball Queen's situation, and I explained further about them "not trying" and then finding out they were pregnant after the injections had started.  Dr. H said it happens all the time when we are making it more fun and not stressing.  It called it, "spontaneous pregnancy."  J said that at some points it did start to feel like work and that was no fun, which is why we decided to take our break and why we kind of thought that had happened when I was late this month.  But "taking a break" from Dr. H could do it.  J said that he never understood the miracle of life until we began this process.  It makes sense now.

Then the real discussion began. We asked what our next steps could be.
1. IUI with more injectible drugs.
        However, he doesn't like this one because even though the success rate goes to about 25%, the down sides are that twins are more possible (15% vs. 5% with regular IUI) and triplets enter the picture (at about 5% chance)!  YIKES!  Now, while that isn't a bad thing to have a couple babies, it is more dangerous for the mother and the children.  Twins conceived this way are 6 times more likely to have special needs and the risk of loss goes way up.  Triplets conceived this way are 8 times more likely to have special needs.  If we did this, it would cost us about $1,000 each time and they would do it 3 times before they said, this isn't working.  Or until I said, "next please!"

2.  IVF (In-vitro)- yes, this is the big kahuna.  The grand daddy of infertility.  The expensive one.  About 12.5x what each IUI cost us last year.  YOWZA!  (Do you see the dollar signs going crazy?!)  I asked him to explain this process because while I knew the generalities of it, I didn't know the specifics.
    First, it takes about 2 months to do because they would put me on birth control to get my follicules in sync to get the most amount of eggs.  How going on BC makes me get more eggs I don't understand, but I believe what he says.  Basically, Dr. H is in control of my cycle.   I do regular fertility pills down the hatch and 10 days of injectible fertility much that I might look pregnant because I have so many eggs going.  I am now a chicken with as many eggs as possible!  Dr. H goes in about day 12 and takes out all my eggs, with me being sedated and out of work.  They are then scrutinized to "separate the good eggs from the bad".  And then they are fertilized with J's boys...this meaning that they crack the shell of my egg and introduce sperm to egg.  (WOW!)  This is called ICSI.  About 5 days later, they put the eggs (max of 2 - not 8 like Octo-mom!  At this point, J asked what Octo-mom's doctor was thinking so there was some discussion about that - Dr. H thinks the guy is a moron.  And then apparently Dr.Octo-mom did the same thing to another woman!) back in me (again sedated) and we hope that one or both implant.  Oh and did I mention the 5 ultrasounds during the course of this process?  Wandy and I will be great friends by the end of this...if we weren't besties already.  So risks - multiple births, but for some reason less chance of special needs issues.  Success rate for our age range and specs is about 50%!  50%!  That is incredible...considerably up from our 15-20%! 
     So during the course of this conversation he kept saying, "frozen embryos" and I had to ask what he meant.  Seems, that whatever eggs are good enough, they freeze and keep until July of the following year.  Frozen eggs apparently give just as good of babies as fresh eggs - WHO KNEW?!  And (God forbid) we have to do this process again, they already have the eggs and don't have to go back and get more which cuts out about $5,000 of the cost!  So the first one is the most expensive.
     Recently I had read about Mini-IVF which was supposedly about 2/3rds of the price so I asked what that was and if they did it.  He said they did not because it basically cut out the embryo freezing and it was actually more cost-efficient to just do the regular IVF because the freezing was included and it cut out the egg retrieval process if we had to go through it more than once.  IVF works better with patients with unexplained infertility (hello - us!) and younger.  Apparently, I still count as "younger" even though I have passed the big 3-0! Again, they would recommend IVF 3 times and if after that it wasn't working, then adoption or surrogacy is our best bet. 
     So that brought up surrogacy, because one of my BFFs offered me the greatest gift ever - her belly!  Basically it would be IVF of my eggs and J's boys in her belly. The only reason they would recommend that was if I was having recurrent miscarriage.  At this point, I am not aware that I have actually ever conceived (remember, I don't know what a positive HPT looks like), so we're not there yet.  (A quick story he told us...there is one form of surrogacy that is actually illegal in Arizona.  Apparently, a surrogate could use her own egg and the spouse's sperm from the mother who couldn't carry.  But it has been banned in AZ because in California there was a case where this happened, and at the end the surrogate decided since it was her egg it was part her baby, so there was a court battle and now the two share custody.  Crazy!  AZ saw that and said, "oh hell no!" and now that can't happen here.  For anyone who wants to research it, it was called Baby M case in California).  We didn't really discuss adoption or a lot about child-free living as he called it, but he let us know those options are available as well.  Child-free living is basically shutting the door.  So that led to a discussion about enjoying what we have before we have kids, but then wanting the other thing too.  We are far from that place right now though.
     I also asked what he recommended.  He said that as long as we are being healthy (eating well, exercising, etc) we don't have to rush anything.  Obviously stats go down as I get older, but if we wanted to wait another couple years, it wouldn't hurt us.  His recommendation was to wait another 6 months to a year and then re-evaluate the situation.  I told him I was doing Weight Watchers and he told me I didn't need to.  (Always nice to hear a doc say that you don't need to lose weight.) He said just to watch portions and exercise and I replied that WW helped me do that and kept my motivation up.  He said that was fine, but not to lose a lot (hello, I can't get past 5 lbs, a lot is not on the plate!).  He said we were some of the slimmest patients he has, so that made me feel good.  Throughout this whole conversation with Dr. H, J is listening intently and asking lots of questions.  He is even bringing up things like my lack of spotting and making sure those are movements in the right direction.  Dr. H agreed they were.  Dr. H was also glad to hear about my Circle & Bloom meditations and had never heard of them.  (I will blog about that another day - but I like it a lot!)  I even asked him if the Healthcare Reform stuff would help or hurt him and he said neither in this practice.  It is more for people who don't have/can't afford insurance and to help the hospitals that don't turn them away and eat the costs, and then everyone's cost go up.  (I don't do politics people, so if this isn't news to you, please forgive.)  It was finally time to go (almost 45 minutes later - our appointment was supposed to be 30 minutes).  We paid and got some more notes from our meeting.  While we are standing there, I noticed a sheet about IVF in a sheet protector with the costs broken down, so I immediately asked for a copy.  It's quite incredible really!

I must say that throughout this conversation, Dr. H was very patient, kind, positive and attentive.  He never rushed us and brought up things to do that wouldn't make him any money.  Which is why I trust him so much.  J and he can talk to each other and get along very well...especially considering where he has to examine me (and I have always had a female OB and never had my husband sitting in the room).  J left to go run some errands and I headed back at the office...stopping at Eegee's on the way for a drink and a cookie (I know, not healthy, but so worth it!) for me and my only employee in the office that day.  Worked until about 6:45 pm, and finally made it home to make dinner and watch a little TV before hitting the hay. After listening to my Circle and Bloom meditation of course. 

Wow, what a day huh?  I think our official decision is to just stay the course we are on...that is, no drugs and no doctors.  Since Dr. H was impressed with my progress as far as the no spotting, etc. we aren't going to worry about more drugs.  And with my big CFP test coming up probably in November, holding back a little bit probably isn't a bad plan.  That test will stress me out enough, no need to add doing IVF or being pregnant in the middle of it to it.  Now, if I "spontaneously impregnate" we won't stop it!  But taking away this stress isn't a bad thing.  Will still keep track of when AF comes and is due, but other than that, nada!  So there is the verdict folks...we are still on a break and loving it.

Now, I happened to see this video that Busted Kate had seen somewhere else about how "Aunt Jane knows more than the singer's RE (fertility doctor)".  It is quite funny because if you are an Infertile, you know these people are everywhere and don't charge nearly what our well-educated REs do.  So watch the video and laugh.

Kate's video.

Night lovely bleaders! Love!

1 comment:

  1. Sounds like a positive meeting with the ever-attentive Dr. H! They know my face as well--even when we hadn't been in for over six months. I think they are really great about getting to know their clients and trying to make it a positive experience for them. Enjoy your "break"...hoping for a "spontaneous impregnation"!


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